Individual
DR. IRINA O. DUDAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4656 W TOUHY AVE, LINCOLNWOOD, IL 60712-1656
(847) 972-2202
(847) 512-4353
Mailing address
2800 N LAKE SHORE DR APT 3609, CHICAGO, IL 60657-6254
(773) 975-1971
(773) 975-1971
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036107984
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
036-107984
IL
207Q00000X
Family Medicine Physician
036107984
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636513
BCBS
IL
05
—
036107984
—
IL
Enumeration date
06/22/2006
Last updated
08/28/2008
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